Help someone in need - Donate Physical Therapy & Rehabilitation equipment and product, Fill this form if you are interested in donation or doing charity

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:: Physiotherapy Equipments ::

Hydro Therapy Equipments

Electro Therapy

Heat & Cold Therapy Equipments

:: Occupational Therapy ::

Positioning Equipments

:: Rehabilitation Aids ::

Walking Sticks / Canes

:: Panchakarma Products ::

Taap Swedan Yantra

Vashap Swedan Yantra

Dravaya Swedan Yantra

Snehan Karma

Pradhan Karma

General Treatment Equipments

:: Medical Furnitures ::

Click here to DONATE our products to those in needs or in remembrance of your loved ones to individuals, hospitals or rehabilitation centres.

Help someone
in need - Donate
Physical Therapy
& Rehabilitation
equipment and product,
Fill this form
if you are interested
in donation or doing
charity

Fill in the following details to help us serve you better. We thank you very much for your interest in our products and your thoughtfullness and kindness for being considerete to those in needs.

Please note that this enquiry form is to be filled only in case the products needed are for donations or charitable institutions, for other requirement click here.

India Medico Instruments reserves the right to demand requisite certificates and/or refuse any request or orders related to donations/charity.

Yes! I/We am/are interested to donate product(s) as an

Individual

Organization

My/Our charity budget is

Upto US $ 50

Between US $ 50 to 100

Between US $ 100 to 500

Between US $ 500 to 1000

Above US $ 1000

No Limit (as per our requirement)

I/We would like to

Take delivery at my/our address

Request you to directly deliver at beneficiary address provided by me/us

Deliver to a known beneficiary to your company as per my budget. Send beneficiary contact information alongwith the receipt to me

Please suggest me/us the product(s)

According to my/our budget

No Thanks! I/We shall notify our requirements ourself. Send me/us quotation as per my/our requirement

My/Our requirement is

My/Our contact information

My Name
Organization Name (if any)
Street Address
City / State		/
Country
Zip / Postal code
Email Address
Website (if any)
Telephone		+ - -
		+(country)-(state)-(tel. number)
Fax		+ - -
Mobile Phone (if any)		+ -
		+(country code)-(mobile number)

Beneficiary contact information

Check it if the Beneficiary Contact Information is same as above

Otherwise fill out the format and give details to whom you wish to donate

Name
Organization Name (if any)
Street Address
City / State		/
Country
Zip / Postal code
Email Address
Website (if any)
Telephone		+ - -
		+(country)-(state)-(tel. number)
Fax		+ - -
Mobile Phone (if any)		+ -
		+(country code)-(mobile number)

Send me/us products catalogue and price list etc.

Update me with all events and product(s) launch.

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